planning your stay with us · 2019. 9. 17. · planning your stay with us. 2 you will have received...
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Planning your stay with us
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You will have received this hospital admission pack following a visit to your specialist as part of the preparation for your proposed admission to St Vincent’s Private Hospital Sydney, Darlinghurst.
STEP ONEIn order to commence your admission process to our facility we require you to complete the following hospital forms:
• Booking and Consent Form (To be completed in the specialists practice) [Your practice may hand this form to the hospital directly or include it within this pack]
• Patient Details Form
• Patient Medical History Form
STEP TWOWhen the above forms have been completed please tear these out of the booklet and ensure that these are returned to us as soon as possible via one of the following options:
1. Use the attached pre-paid envelope to post the forms
2. Scan and email the forms to our pre-admission clinic at;
3. Deliver in person to our Admissions team at;
Level 4, St Vincent’s Private Hospital Sydney 406 Victoria Street Darlinghurst NSW 2010
STEP THREEPlease keep the information booklet for future reference to ensure that you are adequately prepared for your hospital admission with us.
If you have any concerns regarding your admission paperwork you can contact us on (02) 8382 7111.
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Welcome to St Vincent’s Private Hospital SydneyOn behalf of the Sisters of Charity and staff, we warmly welcome you to St Vincent’s Private Hospital Sydney.
For over 100 years St Vincent’s Private Hospital Sydney has excelled in the delivery of quality patient care.
Our patient and family centred care involves you and your loved ones as active members of our team, ensuring that you have the information you need.
To better prepare you for your hospital stay, we encourage you to read through this guide which provides detailed information for you, your family and your friends about your hospitalisation.
Our experienced team of healthcare professionals, support staff and volunteers are equipped to provide the highest level of quality and safe medical and surgical care. We work together with you to optimise your safety, wellbeing and recovery.
St Vincent’s Private Hospital Sydney is recognised as a leader in the provision of exemplary patient care and innovative nursing practice. This is demonstrated by gaining Magnet Redesignation in 2016 and by being awarded the Australian Council on Healthcare Standards Group Gold Medal in 2014 for Quality and Safety.
Our priority is to provide quality and safe patient and family centred care through timely, efficient and effective care in partnership with you and your family.
Tim Daniel, Chief Executive Officer
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Before your admissionPlease discuss any specific questions you may have about your condition with your doctor so that you understand what to expect during your stay in hospital and any subsequent support and/or treatments you may require.
ConsentAny operation, administration of anaesthetics, transfusion of blood/blood products and certain procedures all require your specific consent. Before you give your consent, please ensure that you are confident that your doctor has fully explained the procedure and/or treatment, its effects, your expected recovery and follow-up care requirements. Please ensure that you have had this discussion with your doctor prior to signing your consent.
Informed financial consent Prior to your admission we will provide an estimate of the gap between your health insurance cover and the hospital costs. Otherwise, the estimate will be provided at the earliest opportunity on or after admission. Please be aware that as the estimate is prepared using information supplied by your admitting doctor, circumstances may arise during the course of your hospitalisation that may result in changes to the estimate.
ImportantThis estimate covers your hospital account only. We advise that you check with your health fund if you have any excess or co-payments applicable to your specific level of cover. Any excess or co-payments applicable are payable on or before admission.
We strongly advise that you discuss with your doctor if any prosthesis or medical devices are planned and whether they will incur a gap payment. The hospital will charge this gap payment to you.
Visiting hoursWe know that the presence of friends and family is important to the healing process.
In respecting the care and comfort needs of our patients, visitors are welcome between:
11.00am - 1.00pm and 2.30pm - 8.30pm.
Some areas have specific rest periods outside of these hours. Please discuss with the staff on your ward to confirm.
It is appreciated if the number of visitors at any one time can be kept to a small number especially when patients are in shared accommodation. For the comfort of patients, should you, or your family or friends feel unwell we ask you to refrain from visiting.
The Pre Admission CentreBooking your AppointmentIf you require a medical review prior to your admission you will be contacted by the Preadmission Centre to arrange a Preadmission Appointment. Therefore it’s important that you have provided the correct mobile number and email address on your hospital admission forms.
Your AppointmentIf you attend a preadmission appointment one of our nurses will discuss the information you have provided in your patient medical history form, which is included within this admission pack. It is
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extremely important that this form is fully completed so that we are aware of any health issues.
During this appointment we will discuss allergies and provide you with a plan of care, explain your care and treatment as well as discuss your discharge options. Please make our staff aware of any pre-existing conditions or risk factors such as blood clots, falls at home or chest pain. We will also identify and carry out any tests requested by your doctor which may include; blood and urine tests and an ECG.
However, most importantly this consultation will allow us to address any questions or concerns you or your family may have about your hospitalisation.
Getting the forms back to usIf your admission is within the next seven (7) days please: scan and email to [email protected] or Fax to (02) 8382 7248 or hand deliver to Admissions on Level 4 of St Vincent’s Private Hospital Sydney, 406 Victoria St, Darlinghurst.
If your admission is greater than seven (7) days: scan/email, fax or deliver as above, or mail the forms using the enclosed pre-addressed, free post envelope.
Please bring the following to your appointment:• Your completed Health
Questionnaire if not already returned.
• A list of your current medications with dosage information.
• A list of any allergies to medicines, food, latex, dust, pollen or other sources.
• Any doctors’ letters, scans and X-rays related to your condition.
• Details of your health insurance fund.
• All entitlement cards eg, Medicare, Safety Net, Veterans Affairs, Pensioner Health Card or Health Care Card (if applicable).
• Details of any community services you currently receive.
• Contact details of your General Practitioner.
• At pre admission or on admission, we ask that you supply us with your credit card details which will be entered into our secure system. Any excess, co-payment or estimated out-of-pocket expense will be taken at this time.
Preoperative Telephone AssessmentIf you are unable to attend the Pre Admission Centre, a nurse from the Centre will telephone you to discuss your medical history and make sure you have the information you need about your hospital stay.
Location and ParkingThe centre is located on Level 4 of St Vincent’s Private Hospital Sydney. Free parking is provided to all patients for the duration of your preadmission visit (up to 3 hours only) in St Vincent’s Hospital Sydney car park. The entrance to this car park is located at 390 Victoria Street, Darlinghurst.
On the day of your admissionAdmissionOn the day of your planned admission please arrive at St Vincent’s Private Hospital Sydney main reception desk on Level 4.
For patients who are booked for a medical admission, i.e. not scheduled for surgery, you are asked to arrive at the hospital at the time your doctor advises.
Important• Our patient services
representative will complete your paperwork and ask you to check and confirm that the personal information you provided is correct. Should you have any questions regarding your personal information please refer to our Privacy Policy and advise the staff on admission.
• Whilst every effort is made to meet preferences for single room accommodation, we cannot guarantee that your choice will be available at the time of admission. If you are allocated a private room and your health insurance does not cover private room fees, a gap payment will apply.
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What to bring on AdmissionImportantIf you wear a personal medical alert bracelet chain or band we will ask you to remove the bracelet or band. It will be replaced with the appropriate hospital personal identification band.
Prior to your procedure please:• Shower before your arrival.
Do not apply any powder, creams, lotions, or makeup.
• Follow instructions from your doctor and/or nursing staff including fasting instructions. Failure to do so may result in not being able to have your procedure.
Please bring the following:• All the documentation, scans
and X-rays you have relating to your procedure and/or treatment.
• If you are staying overnight, please bring a small bag with your personal sleepwear, robes, slippers and toiletries.
• All current medications in their original labelled packaging. We are unable to administer medications from Webster packs or Dosette boxes or any medication NOT in their original dispensed packs. If medications are brought to hospital in this form, new medications will be supplied from the hospital pharmacy. This may result in a cost to the patient depending on their health fund coverage.
Personal items and valuables You are encouraged to bring only essential items to the hospital and some small change for the purchase of daily newspapers. Large sums of money, keys, jewellery, personal papers, and other valuables must be left at home. For safety reasons, do not bring hairdryers, hot water bottles, electric blankets, oil burners, candles or incense.• Bring your glasses case with you
to store your glasses. If you wear contact lenses, it is best for you to wear your glasses and leave your lenses at home.
• If you have a hearing aid, bring it and a storage container with you. Please do not wrap your hearing aid in tissue, but always place in the proper storage case.
• If you wear dentures please bring a container for your dentures.
Important• The hospital does not accept
responsibility for loss or damage to any personal property.
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AccommodationSt Vincent’s Private Hospital Sydney offers single and shared rooms with ensuite, television, radio, telephone and refrigerator. We understand that the hospital environment is different from the home environment and can sometimes be confusing, especially at night or if you are in pain. If you would like assistance getting in or out of bed, please use the call bell and wait for nursing staff to assist you. A nurse call system alerts nursing staff when you need assistance. The call bells are situated at every bedside and in the bathrooms.
Make sure the call bell and other needed items are within reach before nursing staff or family leave your room.
Your care teamWe encourage you to actively engage with your healthcare team of doctors, allied health and nursing staff and to participate in your treatment. Nursing care is provided by a professional and experienced team of registered nurses, enrolled nurses, assistants in nursing, and patient care orderlies. As we are a teaching hospital we have medical, nursing and allied health students. Our team of dieticians and nutritionists plan your menu and provide nutritional advice and care.
Other healthcare professionals may also play a role in your care including social workers, radiologists, pharmacists and allied health personnel. Patient services staff assist you on admission and discharge as well
as the receptionists on every ward. Volunteers are highly valued members of the team at St Vincent’s Private Hospital Sydney. They wear a uniform and assist our staff in greeting patients. During the week volunteers tour the hospital with a trolley stocked with newspaper, magazines, confectionery and toiletries.
Your safetyEveryone has a role in making healthcare safe. That includes doctors, healthcare executives, nurses and allied health professionals. As a patient, you can make your care safer by being an active, involved and informed member of your healthcare team.
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DischargeDischarge and after careSome patients may have special requirements for their care following discharge. It is important to identify your needs early so that referrals can be made to services available in your area.
Should you need any of these services and have not made any arrangements ask your nurse to contact a member of the Discharge Planning Team for assistance.
Referrals to the Discharge Planning Team can be made by you, your family, your doctor and/or your nurses to ensure that you have appropriate services organised for when you are ready to be discharged home.
There may be a charge for any community support services put in place, however, a member of the Discharge Planning Team can discuss this with you.
Discharge after your Day Only Procedure• Our staff will notify your relative
or escort with a time that you will be ready to be discharged.
• We recommend that you do not travel on public transport after your procedure (this includes air travel).
• Any medications prescribed following your surgery will be provided to you on your discharge. The cost of discharge medications will be billed to your account and may incur charges not covered by your health insurance company.
• Staff will explain post-operative instructions to you and/or your relative or escort before you are discharged.
• It is recommended that you do not drive a motor vehicle, operate heavy machinery or make important decisions for 24hrs after your anaesthetic.
• You will be discharged once your escort has arrived to accompany you home. It is recommended that someone be with you overnight where possible.
• The following day you will be contacted by phone by a member of the Discharge Nursing team.
• If you are worried about your recovery you should contact your Specialist or the Hospital on the number below.
• If you do not feel comfortable regarding your discharge, please speak to the nurse who will escalate any concerns where necessary.
Emergency ContactIf you need to contact your surgeon urgently, and have been unable to do so, please telephone (02) 8382 7111 and ask for the Assistant Director of Nursing who will assist you.
Discharge after an overnight stayYour discharge from St Vincent’s Private Hospital Sydney will be planned and discussed in advance with you and your family. You will normally be given advance notice of discharge, but on occasions, it may only be possible to notify you on the day of discharge.
Important• For overnight patients discharge
time is 10.00am.• Please ensure that you have
someone to drive or accompany you home.
• The nurse will provide you with a discharge plan that details any services arranged for you by the discharge planning team. Before leaving the ward collect any X-rays and/or medication and confirm whether you have any follow-up appointments.
• Pack and check your room for personal belongings.
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Your accountYour Hospital AccountPrior to your hospital admission we will provide you with an estimate of hospital charges. This estimate will be based upon the following;
• An estimated length of stay for your admission
• Item numbers for your planned procedure(s)
We strongly recommend that you check with your chosen health fund the level of hospital coverage that you have and your eligibility benefits.
It’s important to note that this estimate does not include fees related to treating doctors’ fees or allied health providers.
Please be aware that as the estimate is prepared using information supplied by your admitting doctor and circumstances may arise during the course of your hospitalisation that may result in changes to the estimate.
ImportantAccounts from your doctor, and other specialist consultants who have been involved in your care will be sent to you directly from them. Such services include anaesthetists, assistant surgeons and intensive care specialists. These accounts should be settled directly with the specialist who sends the bill, not the hospital. Medicare and your health fund may cover a portion of the account.
Medical Imaging and Pathology costsThese accounts are not covered in the hospital costs and will be billed separately. They should be settled directly with the service providers. If you have questions or concerns about these costs please contact
• St Vincent’s Clinic Medical Imaging on (02) 8382 7530
• SydPath Account Enquires (02) 8382 2150
Pharmacy costsMedications supplied to patients during their hospital stay and for discharge may result in a cost to the patient depending on health fund coverage. If eligible for subsidised medicines, please supply the card and details on admission. Your health fund may cover a portion of the account.
VeteransThe hospital will ensure that prior approval is received for all White Card holders. Veterans’ Affairs patients who hold Gold Cards do not require approval prior to admission.
Workers’ CompensationIf you have a workers’ compensation claim that has been accepted by the insurance company and you occupied a shared room, you need only pay for any phone, fax or personal laundry charges incurred. If you request a single room, a surcharge will be payable by you and not the insurance company.
Your Doctors AccountsIt is important that you understand that financial accounts from your treating doctors are separate and are not often covered by your health fund or Medicare. Your doctors includes your surgeon(s), medical specialist(s), anaesthetists, intensive care specialists and surgical assistant(s). It is important that you contact your treatment doctors directly for an estimate and that you are aware that they will send the bill directly to you, not the hospital.
We also strongly advise that you discuss with your doctor is any prosthesis or medical devices are planned and whether they will incur a gap payment. The hospital will charge this gap payment to you.
Financial ConsentPayment for your estimated hospital fees, gaps or excess is required on admission. Full fee paying patients will be required to pay 100% of the estimated fee before on the day of admission to St Vincent’s Private Hospital Sydney.
Circumstances may also occur during your hospitalisation that will result in additional fee charges. A credit card pre¬ authorisation or cash deposit against additional expenses is also required on admission. Upon being admitted to St Vincent’s Private Hospital Sydney, you agree to pay all fees relating to your hospital visit, including where your health fund or insurance claim is declined for any reason.
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Privately Insured PatientsIf you have private health insurance we will submit a benefits claim form on your behalf. Following the submission of your claim any out of pocket expenses not covered by
your health fund will need to be paid.
Uninsured patientsIf you are an uninsured patient you will be required to pay the full estimate of your account on, or before the day of your admission. Fees for additional or unplanned services are payable on discharge. Please call in to the admissions area on Level 4 to settle your account
Payment optionsThe hospital accepts payment via the following options:
• Major credit cards, cheque, cash EFTPOS or direct bank deposit
• Personal cheques up to $1,000 are acceptable for excess or co-payments (please note. no cheques will be accepted on the day of admission from patients who are self-funded, are from overseas or have restrictions with their health fund cover)
At your preadmission appointment or on your day or admission to hospital we ask that you supply us with your credit card details which will be entered into our secure system. Any excess or co-payments will be taken at this time. If you have previously paid an excess or co-payment within the last 12 month, please bring your receipts with you.
All accounts may not be finalised at the time of discharge from hospital. You may experience some additional debits made to your credit card that were incurred during your stay such as pharmacy costs or ECG’s. You will be contacted by one of our team is the amount is greater than $500.00.
Patient and visitor amenitiesIn your room you will find a patient information booklet which includes details of all the services we offer.
Accommodation for visitors At St Vincent’s Private Hospital Sydney there are no sleeping arrangements available for relatives of patients. However, a range of local hotels offer discounted accommodation for country or interstate visitors. Reception has a brochure listing all local accommodations as does the discharge planning brochure.
Advice on how to make a compliment, a complaint or a suggestion about your health care treatment.You are invited to provide feedback about the services you received in hospital. If you or your family have any concerns during your stay, please direct them to the staff caring for you or the Nurse Unit Manager. If you would like to make a statement about the care you received, please use the consumer feedback form available from the receptionist on each ward. A reply-paid envelope is available should you wish to take the form home and complete it at a later date. Alternatively you can visit our website and complete a consumer feedback form electronically.
Alcohol and recreational drugsAlcohol and recreational drugs must not be consumed or taken before any procedure or in conjunction with medication.
Assistance with mealsIf you require assistance to eat your meal, open food packages or would like your meal to be cut up so it is easier to eat, please inform your nurse or nutrition assistant who visits you for your menu selections.
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Fire safetySt Vincent’s Private Hospital Sydney is committed to the safety of all patients, visitors and staff. Candles and naked flames are not permitted in the patient care areas of the hospital. Emergency procedures are in place and regular fire drills are conducted with all staff. In the event that you discover an emergency, please press the nurse call button. Our trained emergency team will attend to any emergency and manage the situation. We ask that you remain calm and wait for instruction from our staff.
FlowersOrders for floral arrangements, for any occasion, can be placed by calling Fragrant Plum Florist from Monday to Friday from 9.00am to 5.00pm and Saturday from 9.00am to 3.00pm. From within the hospital dial 23032 or if calling externally call (02) 8382 3032.
Food and Nutrition Services Food and Nutrition Services are an integral part of your healthcare experience at St Vincent’s Private Hospital Sydney. The food services team aims to provide you with nutritious and rewarding meals to aid your recovery.
Assistance with meals Please let your nurse know if you require assistance to get ready for your meal, i.e. sit up and/or get out of bed.
Special dietsWhile in hospital, you may need to go onto a special diet, with foods that are different in texture and/or taste to what you’re used to having at home – this is to assist your recovery. Please let staff know if you have any questions or concerns regarding your special diet. On occasion, during your stay, your diet order may need to be changed for medical reasons.
Churches and other places of worshipA chapel is located on Level 4 of St Vincent’s Private Hospital Sydney and is open daily from 7.00am to 9.00pm. Mass is celebrated at 12.30pm on Wednesdays, and 10.00am on Sundays and is televised throughout the hospital on channel 3.
Please find a brochure at reception or the chapel for a listing of all Eucharist celebrations across the campus. A Catholic chaplain is available to patients, families and staff and the sacrament of the sick and reconciliation are available through pastoral services.
Although a distinctly Catholic organisation, our mission is the care of all patients. With this in mind chaplains from various faith traditions and denominations regularly visit St Vincent’s Private Hospital Sydney.
These chaplains are officially endorsed and considered integral to the work of the pastoral care team. Visits can be arranged by contacting your pastoral carer.
If you choose, your own Minister, Priest, Rabbi or Spiritual Advisor is welcome to visit you.
Coffee shopThe Wintergarden coffee shop is located on level 4 of St Vincent’s Clinic. It is open on Monday to Friday from 7.00am to 6.00pm. Closed on Saturdays, Sundays and public holidays.
The Foyer Coffee Cart operates from 7.00am to 6.00pm Monday to Friday and weekends 8.30am to 4.00pm.
Companion animalsProvision is made for patients who are visually impaired to have their companion or assistance animal with them. Please advise your requirements prior to admission.
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This may mean that the meal you ordered is no longer suitable for you, however, a meal that is suitable will be provided.
Guest mealsSpecial circumstances may permit a guest meal to be ordered for a visitor. Guest meals are charged to the patient’s account. A standard meal will be served and no dietary restrictions will be catered for. For more information please see the receptionist on the ward.
Can I bring in food for a patient?As much as hospitals try, the food that is served may not meet expectations — especially when people don’t feel well. As a result, your loved ones may be tempted to bring a meal or a special treat into the hospital to show their concern and to help make you feel better As appealing as home cooked food may sound during your hospital stay, we discourage family members and friends from bringing food for several reasons:
• It may not meet your specific health needs – you may be on a restricted diet due to your condition or preparing for a surgical procedure. When you eat food brought from home you risk interfering with the diet you need during your hospital stay.
• It may make you sicker – there is an increased risk of food poisoning when food is not properly prepared, transported or stored. This can have serious consequences for someone with a compromised immune system.
The comfort and wellbeing of each of our patients is our primary concern. For these reasons, St Vincent’s Private Hospital Sydney cannot accept responsibility for food that is prepared outside the hospital and is brought in for patients by relatives and visitors.
Should you feel home cooked meals are necessary, please follow the guidelines in the brochure, Guidelines for bringing occasional food or drinks in for patients. This is available at reception.
LaundryAn overnight laundry service is available at a cost with items collected by 10.00am and returned the next morning. This service does not include ironing.
Library serviceOur volunteers provide a library service offering the loan of books and magazines.
Mobile phonesThe use of mobile phones should be restricted to essential calls only. Unnecessary phone calls may interfere with the normal enjoyment of the environment and the facility.
NewspapersDaily newspapers are sold through Volunteer Services, Monday to Friday, from 8.00am to 12.00 noon. Please bring small change for purchases.
Outreach Gift ShopLocated on Level 4 of St Vincent’s Clinic, the Outreach Gift Shop sells gifts and other novelty items with proceeds supporting numerous community services. The Outreach Gift Shop is open weekdays from 9.00am until 4.00pm.
For more information dial 26340 from your room or if calling externally call (02) 8382 6430.
Pastoral CareAs part of our holistic approach to your care, pastoral carers are available to be a listening and compassionate presence offering emotional and spiritual support where confidentiality is respected.
If requested, Catholic and Anglican chaplains are available, with regular visits by Jewish, Presbyterian,
Uniting Church, Greek Orthodox, Salvation Army, Seventh Day Adventist and Catholic French speaking chaplains.
PharmacySt Vincent’s Private Hospital Pharmacy is located in the foyer of the hospital and stocks a wide range of personal and healthcare products, Natio cosmetics and skin care, confectionery, gifts, stamps, cards and flowers. Cosmac Healthcare is located within the pharmacy and our fitting specialists are available to fit travel and compression stockings and other surgical appliances.
Operating hours are from 8.30am to 5.15pm from Monday to Friday.
Pharmacy: (02) 8382 7465 Cosmac: (02) 8382 7257
SmokingAs legislated by NSW Health, smoking is prohibited in all areas within St Vincent’s Private Hospital Sydney and St Vincent’s Clinic. This includes all entrances and external areas.
Wireless Internet access and loan notebooksSt Vincent’s Private Hospital Sydney has a wireless network installed across all patient levels that enables immediate access to the Internet for patients who bring their own devices. Connection instructions are available from the receptionist on the ward and are also displayed on the screen once you are connected to the wireless network called MA-Ministries and have selected Patient WiFi Access on the login page.
Your user name is your patient ID displayed on your wristband and your password is your date of birth backwards - yymmdd (eg. if date of birth is 12 April 1945, password will be 450412).
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Privacy and your health informationSt Vincent’s Private Hospital Sydney is a values-based organisation committed to ensuring that your personal information is managed in accordance with the Australian Privacy Principles outlined in the Privacy Act 1988, Health Records and Information Privacy Act 2002 (NSW) and relevant State Privacy Legislation. In order to provide you with healthcare services, we need to collect, use and disclose your personal information. Our privacy policy outlines how we manage your personal information.
Use of personal information
CollectionWe collect your personal information for the primary purpose of providing healthcare and treatment. We only collect information that is relevant and necessary to provide you with these services and to assist with the activities of the St Vincent’s Private Hospital Sydney.
Generally information will be collected from you directly, however information may also need to be collected from other sources.
These sources may include other health professionals, health services providers, health funds, insurance agencies and in certain situations, other family members, carers, or friends.
Use and disclosureWe will use or disclose your personal information for purposes directly related to your treatment, and in ways that you would reasonably expect for your ongoing care. This includes sharing your personal information amongst members of your healthcare team, including doctors, nurses, allied health professionals and pastoral care providers. We may also provide relevant information to health professionals involved in your ongoing care after you leave hospital.
Some services provided by contractors within the hospital may require the disclosure of your personal information for the provision of those services.
We have various legal obligations to provide various data sets of information about our patients to State and Commonwealth Government agencies, health funds and the Private Hospitals Data Bureau. Your personal information may also be subpoenaed if required as evidence in court.
We may use or disclose patient information for our internal administrative requirements, statutory reporting, quality improvement activities and other purposes required for the operation of the hospital.
We may use or disclose your information for the following purposes in accordance with Statutory Guidelines issued under the privacy law:
• Another hospital may contact us to obtain information about you, so that they can treat you safely and effectively. We will only release information about you to assist with your care after confirming the identity of the person requesting your health information and the urgency of the situation. Wherever possible we will attempt to obtain your consent.
• To assist other medical practitioners or institutions who may treat you in the future. We will only release information about you to the extent necessary to treat the particular condition for which you have given your consent to the medical practitioner or institution. This may include forwarding relevant prior information (eg, anaesthesia records).
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• To inform next of kin identified in your admission form of the outcome of treatment or to obtain consent to necessary treatment when you are not able to provide such consent.
• For research and development projects undertaken by St Vincent’s Private Hospital Sydney in its own right or in conjunction with other organisations.
• To assist St Vincent’s Private Hospital Sydney to provide members of Ministries of Religion with sufficient details to enable them to visit you whilst you are a patient in this facility.
• To communicate marketing initiatives or promotional offers and special events to you.
• To contact you and invite you to make a contribution to or assist in fundraising activities.
• For public interest research projects which comply with strict protocols and are approved by a Human Research and Ethics Committee and are undertaken by St Vincent’s Private Hospital Sydney in its own right or in conjunction with other organisations.
• For other planning, financial or management purposes for health service activities.
• To assist St Vincent’s Private Hospital Sydney in providing practical training and education to medical, nursing and other allied health students.
• After you leave hospital you may receive a text message or email inviting you to complete a short survey about your experience with us.
You may at any time withdraw your consent, other than as required for operation of our business. The Statutory Guidelines ensure that where your information is needed for these purposes and
it is impracticable to seek your consent, a minimum amount of personal information is used, and the personal information is handled in accordance with strict standards.
Storage and RetentionYour personal information is stored:a) as a paper health record in
dedicated secure storage areas throughout the hospital or at an offsite storage location contracted to St Vincent’s Private Hospital Sydney, and
b) as electronic records in a secure environment.
All information held is only accessible by authorised persons for the purpose of carrying out their employment duties. We will destroy or de-identify personal information after our legal obligations to retain the information have expired.
AccessYou may request access to information St Vincent’s Private Hospital Sydney holds about you by writing to the Hospital Privacy Officer at the address below. A response will be provided to you within 30 days. Where St Vincent’s Private Hospital Sydney holds information that you are entitled to access, we will endeavour to provide you with a suitable range of choices of how you access it. There may be times when we cannot grant access, and we will provide you with a reason if this is the case. A charge may be associated with your request. An Application Form is available on request.
AmendmentIf you believe that the personal information St Vincent’s Private Hospital Sydney holds is incomplete or inaccurate, then you may write to us asking for it to be amended. If we do not agree that there are grounds for amendment,
then we will insert an addendum (noting your view) into your record. An Amendment Form is available on request.
Contact usIf you have any further questions or complaints concerning the privacy of your personal information, please contact our Quality Office:
The Quality Manager Quality and Risk Services St Vincent’s Private Hospital Sydney Locked Bag No. 5 Darlinghurst NSW 2010
Tel: (02) 8382 7111 Email: [email protected]
If you are not satisfied with the way in which we handle your information or deal with your privacy concerns, you may wish to make a formal complaint to the Office of the Australian Privacy Commissioner:
Tel: 1300 363 992 Website: www.oaic.gov.au
Please see our website for further information: www.svphs.org.au/privacy-policy
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Understanding your rights and responsibilitiesAt St Vincent’s Private Hospital Sydney we support the Australian Charter of Healthcare Rights.
The Australian Charter of Healthcare Rights describes the rights of patients and other people using the Australian health system. These rights are essential to make sure that, wherever and whenever care is provided, it is of high quality and is safe.
The Charter recognises that people receiving care and people providing care all have important parts to play in achieving healthcare rights. The Charter allows patients, consumers, families, carers and services providing health care to share an understanding of the rights of people receiving health care. This helps everyone to work together towards a safe and high quality health system. A genuine partnership between patients, consumers and providers is important so that everyone achieves the best possible outcomes.
Guiding PrinciplesThese three principles describe how this Charter applies in the Australian health system.
1. Everyone has the right to be able to access health care and this right is essential for the Charter to be meaningful.
2. The Australian Government commits to international agreements about human rights which recognise everyone’s right to have the highest possible standard of physical and mental health.
3. Australia is a society made up of people with different cultures and ways of life, and the Charter acknowledges and respects these differences.
Your responsibilities• To provide accurate and complete information about your condition,
past illness and medications as outlined in our health questionnaire.• To consider other patients in our care. In particular, we ask for your
co-operation with the control of noise, respect of property and the observation of the non-smoking policy within the buildings of St Vincent’s Private Hospital Sydney.
• To treat all the healthcare workers employed by St Vincent’s Private Hospital Sydney with respect and courtesy regardless of their cultural and ethnic backgrounds.
• It is important that you check with your private health insurer that your insurance is up to date, as co-payments, excess and costs for excluded procedures are your responsibility.
What can I expect from the Australian health system?MY RIGHTS WHAT THIS MEANS
ACCESS - I have a right to health care. I can access services to address my healthcare needs.
SAFETY - I have a right to receive safe and high quality care.
I receive safe and high quality health services, provided with professional care, skill and competence.
RESPECT - I have a right to be shown respect, dignity and consideration.
The care provided shows respect to me and my culture, beliefs, values and personal characteristics.
COMMUNICATION - I have a right to be informed about services, treatment, options and costs in a clear and open way.
I receive open, timely and appropriate communication about my health care in a way I can understand.
PARTICIPATION - I have a right to be included in decisions and choices about my care.
I may join in making decisions and choices about my care and about health service planning.
PRIVACY - I have a right to privacy and confidentiality of my personal information.
My personal privacy is maintained and proper handling of my personal health and other information is assured.
COMMENT - I have a right to comment on my care and to have my concerns addressed.
I can comment on or complain about my care and have my concerns dealt with properly and promptly.
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10 tips for safer healthcareThis summary has been produced by the Australian Council for Safety and Quality in Health Care, which has been set up by Commonwealth, State and Territory governments to improve the safety of health care in Australia. These 10 Tips* can help you to become more active in your healthcare. More questions you might want to ask your health care professional are contained in the 10 Tips for Safer Health Care booklet.
1. Be actively involved in your own health care• Take part in every decision to
help prevent things from going wrong and get the best possible care for your needs.
2. Speak up if you have any questions or concerns• Ask questions.• Expect answers that you can
understand.• Ask a family member, carer or
interpreter to be there with you, if you want.
3. Learn more about your condition or treatments• Collect as much reliable
information as you can.• Ask your health care
professional: - what should I look out for? - please tell me more about my condition, tests and treatment. - how will the tests or treatments help me and what is involved? - what are the risks and what is likely to happen if I don’t have this treatment?
4. Keep a list of all the medicines you are taking• Include:
- prescriptions, over-the-counter and complementary - medicines (eg, vitamins and herbs); and - information about drug allergies you may have.
5. Make sure you understand the medicines you are taking• Read the label, including the
warnings.• Make sure it is what your doctor
ordered for you.• Ask about:
- directions for use; - possible side effects or interactions; and - how long you’ll need to take it for.
6. Get the results of any test or procedure• Call your doctor to find out your
results.• Ask what they mean for your care.
7. Talk about your options if you need to go into hospital• Ask:
- how quickly does this need to happen? - is there an option to have the surgery/procedure done as a day patient, or in an alternative hospital?
8. Make sure you understand what will happen if you need surgery or a procedure• Ask:
- what will the surgery or procedure involve and are there any risks? - are there other possible treatments? - how much will it cost?
Tell your health care professionals if you have allergies or if you have ever had a bad reaction to an anaesthetic or any other drug.
9. Make sure you, your doctor and your surgeon all agree on exactly what will be done• Confirm which operation will be
performed and where, as close as possible to it happening.
10. Before you leave hospital, ask your health care professional to explain the treatment plan you will use at home• Make sure you understand your
continuing treatment, medicines and follow-up care.
• Visit your GP as soon as possible after you are discharged.
Find out more about the Safety and Quality Council or obtain copies of 10 Tips for Safer Health Care by calling (02) 6289 4244 or from its website at www.safetyandquality.org
*These 10 Tips have been adapted from the
US Agency for Healthcare Research and
Quality patient fact sheets (available on the
Internet at www.ahrq.gov/consumer).
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PATIENT DETAILS FORM Please complete and return to the hospital as soon as possible by reply paid envelope, email or in person to hospital reception located on level 4. To submit this form via email, please send to [email protected] For any enquirers, please contact the hospital on (02) 8382 7111.
ADMISSION DETAILS
Admission Date: Admitting Doctor:
Type of Admission: Day Only Overnight
Have you been a patient in St Vincent’s Private Hospital Sydney before? No Yes If YES which year?
PATIENT DETAILS
Title: Surname: Previous Surname (if applicable):
Given Names: Preferred Name:
Date of Birth: Sex: Male Female
Residential Address: Suburb:
State: Postcode:
Postal Address the same as Residential: Yes No
If NO, Postal Address: Suburb:
State: Postcode:
Telephone (Home): Mobile: Business:
Email address:
Marital Status: Single Married Divorced Widowed Separated Defacto
Religion:
Ethnicity: Aboriginal Torres Strait Islander Both Neither
Country of Birth: Year of arrival in Australia: [ ] N/A
Do you require an interpreter? No Yes If YES, main language spoken at home:
MEDICARE DETAILS
Do you have Medicare? Yes No
If YES, Card number: No. beside patient on card: Valid to: /
HOSPITAL ACCOUNT DETAILS (select as applicable)
Private Health Fund Fund name: Membership number:
Workers Compensation / Third Party Claim number (if known):
Defence Force
DVA Card number: Card colour: Gold White Orange
Other:
PHARMACY ENTITLEMENT CARD(S) (select as applicable)
Pension/Concession Card number: Valid to: / /
Safety Net Card Card number: Valid to: / /
FAMILY DOCTOR (GP)
Who is your family doctor / GP?
Practice Name: Phone number:
Address: Suburb:
PLEASE TURN OVER AND COMPLETE BACK OF FORM
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PERSON TO CONTACT / PERSON RESPONSIBLE
Name: Relationship to patient:
Address: Suburb: State:
Postcode: Main phone number: Additional phone number:
NEXT OF KIN
Is Next of Kin the same as Person to Contact/Person Responsible? Yes No
If NO Name: Relationship to patient:
Address: Suburb: State:
Postcode: Main phone number: Additional phone number:
ADVANCE CARE DIRECTIVE/ ENDURING GUARDIAN
Do you have an Advance Care Directive? Yes No
If Yes, have you brought a copy of your directive to Hospital? Yes No
Do you have an Enduring Guardian Yes No
Name: Relationship to patient:
Address: Suburb: State:
Postcode: Main phone number:
EMERGENCY CONTACT
Is there an additional person to contact in case of emergency? No Yes
If YES, Name: Relationship to patient:
Main phone number: Additional phone number:
PREFERRED ACCOMMODATION (overnight patients only)
Whilst every effort is made to accommodate your request, we cannot always guarantee availability on day of admission.
Please indicate your preferred accommodation: Private Room Shared (2 bed) Room
DECLARATION - to be signed by patient / person responsible
I certify that the above information is true to the best of my knowledge.
Signed: Date: / /
Please print name:
Please indicate who has completed the form: Patient Person Responsible
DAY SURGERY UNIT PATIENTS - IF GOING HOME ON THE DAY OF SURGERY
Please note that all patients going home on the day of surgery after having an anaesthetic (general or sedation) MUST have a responsible adult collect them from the Day Surgery Unit (DSU) and accompany them home.As a guide most patients are discharged 4 hours after their admission. Either you or the DSU staff can contact your escort when you are ready to go home. If you fail to comply with these safety requirements your surgery will be postponed until another day when you are able to provide an escort to take you home.
• I have arranged for a responsible adult to accompany me home Yes
• I am aware that I should have someone stay with me overnight after surgery Yes
Name of person collecting me:
Contact number(s)
If you are coming from outside of Sydney please provide details of your accommodation in Sydney and contact number(s)
Name:
Contact number(s)
Please complete and return to the hospital as soon as possible by reply paid envelope, or email:St Vincent’s Private - Phone: 8382 7111 - Email: [email protected]
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MEDICAL HISTORYHave you ever had or now have: (Please tick) (Please tick)
Heart Trouble Blood Disorder / Anaemia
Heart Attack Blood Clot / DVT
Chest Pain Indigestion or Ulcer Trouble
Indigestion Pain Reflux or Heartburn
Rheumatic Fever Gall Bladder Trouble
High Blood Pressure Stroke
Palpitations Any recent episodes of fits or fainting?
Shortness of Breath Epilepsy
Asthma Muscle Weakness
Collapsed Lung Sleep Apnoea
Have you had a cold, flu recently Are you pregnant?
Do you have a Cough Are you or could you be HIV +ve
Medical Devices Pacemaker Spinal Stimulator Pain Infusion device Other:
Internal Defibrillator Loop Recorder Bi-ventricular device
Kidney Trouble Dialysis Failure Infection Stones
Arthritis Osteoarthritis Rheumatoid Gout Other:
Diabetes Controlled by: Diet Injection Tablet Year diagnosed:
Cancer Type: Year:
Organ transplant Type: Year:
Hepatitis/ Jaundice Type: Year:
MRSA (Multi-Resistant Staph Aureus / ‘Golden Staph’) Location: Year:
Have you ever had a Blood Transfusion? YES NO If yes, year:
Do you have Creutzfeldt-Jakob Disease CJD YES NO Were you given Human Pituitary Growth Hormone prior to 1985 YES NO Did you have neurosurgery prior to 1985? YES NO Do you have a fear of falling? YES NO
Have you had a fall recently? YES NO Details:
PREVIOUS DRUGS TAKEN Have you ever taken: (Please tick) (Please tick)
Drugs for Diabetes Drugs for Asthma
Drugs for Heart Trouble Drugs for Arthritis / Anti-inflammatories
Drugs for High Blood Pressure Drugs for Nerves or Sleeplessness
Drugs to stop Blood Clotting Any Cortisone in the last 6 months
SMOKING / ALCOHOL HISTORY (Please tick)
Do you smoke? YES NO If yes, how many cigarettes or pipes do you smoke a day?:
Have you ever smoked? YES NO If yes, when did you give up?:
Do you drink alcohol? YES NO If yes, how often? Daily Weekly Occasionally
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Spirits
1 2 3 4+
Wine
1 2 3 4+
Beer
1 2 3 4+
Other
1 2 3 4+
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OTHERIs there any other relevant medical history?
ANAESTHETIC HISTORYPlease list any previous operations: Year Please list any previous operations: Year
Have you had any problems with General Anaesthetic? e.g. Difficult intubation / malignant hyperthermia YES NO
Have you had any problems with Local Anaesthetic? YES NO
Any family member had problems with Anaesthetic? e.g. Difficult intubation / malignant hyperthermia YES NO
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CURRENT MEDICATIONPLEASE LIST ALL THE MEDICATIONS, TABLETS, EYE DROPS OR INJECTIONS THAT YOU NORMALLY TAKE - including any oral contraceptives, naturopathic remedies, vitamins, products from the Health Food store or “recreational drugs”
Name of Drug Dose How many times a day If stopped, when?
e.g. Panadol e.g. 2 tablets e.g. twice a day
ALLERGIES & ADVERSE REACTIONS (Please tick)
Do you have any known allergies YES NO
If you are allergic to, or have had a reaction to any medications, food, tapes, lotions or other substances such as LATEX or
RUBBER please provide details below:
Allergic to Type of Reaction
WEIGHT & HEIGHT What do you weigh? (approx) kg (or stone pounds)
How tall are you? (approx) cm (or feet inches)
Patient Medical History
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Do you have any eating difficulties or special eating requirements? YES NO
If yes, please indicate
Are you on a special diet? YES NO
If yes, please indicate
Has your weight changed much in the past few months? YES NO
If yes, over how many months?
What has brought about this change?
FUNCTIONAL ASSESSMENT Do You have or use any of the following PROSTHESES: (Please tick)
Mouth: Caps Crowns Dentures Bottom (Full) Dentures Bottom (Partial)
Dentures Top (Full) Dentures Top (Partial) Plate - Upper Plate - Lower
Ears: Hearing aid Cochlear implant
Eyes: Glasses Contact Lens Intra-ocular lens Prosthetic eye
Limbs: Artificial limb Crutches Leg Brace Walking Stick
Do you have any problems with:
Decayed Teeth Dementia Confusion Memory loss
Mental illness Mouth Ulcers Speech difficulties Swallowing
Do you have a:
Colostomy Urostomy/Ileal conduit lleostomy Neobladder
Peg tube Tracheostomy
Do you experience:
Urinary Frequency Incontinence Nocturia Constipation
Diarrhoea Irritable bowel
Do you: Self catheterise have an Indwelling catheter have a Supra-pubic catheter
Do you have any skin problems? If so, where are they located:
Cuts or Abrasions
Frail skin
Psoriasis
Sores
Wounds
Location
Eczema
History of pressure areas
Rash
Ulcers
Location
Do you need assistance with:
Bathing / Personal hygiene Dressing Repositioning in bed Walking
Do you have any pain? YES NO
If yes, where is the pain?
Patient Medical History
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Patient Medical History
PLANNING FOR YOUR DISCHARGE (Please tick)
Do you live alone? YES NO Are you a carer for someone else? YES NO
(If yes to either question, please provide details)
Services used BEFORE Admission (Please tick) Services used AFTER Admission (Please tick)
Community nurse Community nurse
Assistance with cleaning Assistance with cleaning
Assistance with hygiene Assistance with hygiene
Assistance with shopping Assistance with shopping
Respite in the home Respite in the home
Privately delivered meals Privately delivered meals
Meals on wheels Meals on wheels
Hostel placement Hostel placement
Nursing home placement Nursing home placement
Respite in hostel / nursing home Respite in hostel / nursing home
Travel assistance Travel assistance
Other (please specify) Other (please specify)
Destination on discharge from St Vincent's Private Hospital (Please tick)
Home alone
Home alone with assistance of family or friends
Home to relative or friend’s home
Hostel or retirement village
Rehabilitation
Other (please specify below)
Comments
Household Arrangements (Please tick)
You live in a: Flat House Other:
Fittings: Bath Rails Where are the rails located?
Shower over bath Shower recess
Access: Stairs (internal) Stairs (external) How many stairs are there?
Lift Wheelchair access
Do you drive a car?: YES NO Automatic Manual
SIGNATURE
Patient Signature:
Patient Name: (Please print) Date:
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Visitor car parking guideSt Vincent’s Private Hospital SydneyThere is no parking available at St Vincent’s Private Hospital Sydney, however, secure parking is available at the co-located St Vincent’s Hospital Sydney and St Vincent’s Clinic. Limited metered and unmetered parking is also available in the surrounding streets.
St Vincent’s Hospital Sydney – preferred parking option for visitors before 5.00pm
Operated by PARKSMART Tel: 02 8097 8344
Visitor parking is available:
Monday to Thursday: 6.30am to 11.30pm
Friday and Saturday: 6.30am to 1.30am
Sunday: 6.30am to 12.00 midnight
Enter via Victoria Street, Darlinghurst. Tickets are issued on entry at the boom gate. Please pay the attendant in the car park booth on exit. Some dedicated disabled parking is available.
St Vincent’s Clinic – preferred parking option for visitors after 5.00pm
Limited visitor parking is available:
Monday to Friday: 6.00am–9.00pm (Last entry at 8.00pm)
Enter via Barcom Avenue, Darlinghurst. Tickets are issued at the entry boom gate. Please pay at the pay stations on Level 2 or Level 4.
Disabled parking:Dedicated disabled parking is available on Level 1.
Drop off Zone:A five minute drop off zone is available at the front of St Vincent’s Private Hospital Sydney and St Vincent’s Clinic (Victoria Street).
Parking charges: Please see the website www.svphs.org.au
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352 - Marrickville Metro to Bondi Junction via Newtown, The University of Sydney, Chippendale, Surry Hills, Darlinghurst and Paddington.
380 - North Bondi to City - Circular Quay via Bondi Beach, Bondi Junction, Paddington and Darlinghurst.
389 - North Bondi to Pyrmont via Bondi Junction, Woollahra, Paddington, Darlinghurst, East Sydney, City, The Star and Maritime Museum.
440 - Bondi Junction to Rozelle via Paddington.
M40 - From Chatswood to Bondi Junction via City.
M10 - From Leichhardt to Maroubra via the City.
Train:Closest station is Kings Cross on the Eastern Suburbs Line. St Vincent’s Private Hospital Sydney is a 15 minute walk from the station along Victoria Street.
We hope that the following information will be of assistance to you in planning your transportation to and from St Vincent’s Private Hospital Sydney.
Hospital street address:406 Victoria Street, Darlinghurst Sydney, Australia (Nearest cross street is Oxford Street)
Postal address:Locked Bag No 5, Darlinghurst NSW 2010
Tel: (02) 8382 7111 Fax: (02) 8382 7234
Public transportBus:311 - Railway Square to City - Millers Point via Darlinghurst, Kings Cross, Elizabeth Bay, Potts Point, Woolloomooloo and City - Town Hall.
333 - North Bondi to City - Circular Quay LIMITED STOPS (PrePay-only) via Bondi Beach, Bondi Junction, Paddington and Darlinghurst.
Taxi:A taxi telephone is located in the foyer. Alternatively, the following companies service the area:
• ABC Taxis: 13 2522• Combined Taxis: 13 3300• Legion Cabs: 13 1451• Silver Service: 13 3100
CountryCare Link:Operated by Sisters of Charity Outreach, Country Care Link is a free transport service for country people coming to, and going home from, St Vincent’s Private Hospital Sydney. Transport is provided by one of our friendly, trained volunteer drivers between the airport, railway or bus station and the hospital. To book, or for further information, contact 02 8382 6434 or [email protected]
Correct at time of printing April 2019
Location and transport
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St Vincent’s Private Hospital Sydney406 Victoria Street Darlinghurst NSW 2010 Tel: (02) 8382 7111 www.svphs.org.au
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